Self-management of fatigue: More than “taking it easy”

Pretty much everyone with multiple sclerosis has felt MS-related fatigue. You know what I am talking about – not the tiredness that people complain about after a late night or a day of holiday shopping, but bone-crushing weariness that makes you doubt whether you can continue to function for even an hour more, much less until the end of the day. For me, fatigue is often accompanied by nausea and a headache, not to mention a worsening of sensory symptoms, such as tingling feet and the MS hug. With all of that going on, cognitive function goes out the window, adding to the frustration of the whole terrible situation.
I attended a session on self-management of fatigue a few weeks ago at ECTRIMS 2013, presented by Dr. Marcia Finlayson, an expert in occupational therapy. She said that she has heard people describe fatigue as a “constant heaviness, like walking in cement” and as “debilitating,” “scary” and “discouraging.”
However, she also offered some insight into what people with MS-related fatigue could do to actively fight their fatigue. While you may have heard well-meaning people offer the advice to “rest more” or “cut back on stress” to deal with fatigue, there is much more to successfully making any headway against this symptom. Self-management is defined as a dynamic process of day-to-day management of a chronic condition, in this case, fatigue.
There are several different components to successful self-management of fatigue. Today, I’d like to explore the physical steps you can take to manage fatigue, and then next week I’ll look at the emotional and environmental factors.
Medical management of fatigue:
  • You need to monitor your fatigue, so that you know if there is something triggering or exacerbating your fatigue. Being aware of your fatigue levels over time will also help you know if any of the measures that you are taking are helping your fatigue.
  • Of course, you should seek help when you are having relapses – see your doctor for any new or worsening symptoms lasting more than 24-48 hours. Your doctor may want to give you a course of Solu-medrol or other medication to shorten the duration of your relapse.
  • Take any medication that your doctor has prescribed. There are some medications that help reduce fatigue directly. Other medications may help secondary fatigue by alleviating symptoms that are interfering with sleep.
Role management:
  • You may have to give up some roles – for instance, it may be too much to continue to coach the soccer team or to actively manage high-pressure projects at work.
  • Part of role management may also involve finding new roles or shifting responsibilities within roles. You may need to find other ways to be involved in your child’s activities or take on different duties at work.
These are just a few things I’ve learned. Check back next week to learn more about emotional and environmental aspects of fatigue. And, share your tips for managing fatigue in the comments section below.
Tags Research, Symptoms      16 Appreciate this

Julie Stachowiak, PhD

Julie is the author of the Multiple Sclerosis Manifesto, the winner of the 2009 ForeWord Book of the Year Award in the Health Category. She is an epidemiologist who is also a person living with MS, Julie has an in-depth understanding about current research and scientific developments around MS. She also has first-hand knowledge of the frustrations and anxiety surrounding the disease, as she had MS for at least 15 years before receiving a diagnosis in 2003 and has had several relapses since her diagnosis.